RESUMO
A 2003 partnership between the Institute for Healthcare Improvement and the Robert Wood Johnson Foundation created an initiative to redesign medical-surgical inpatient care - Transforming Care at the Bedside (TCAB). TCAB is intended to transform the elements that affect care on medical/surgical units by rapidly creating, testing, and measuring new ideas. TCAB began as a pilot with three hospitals nationwide, including the University of Pittsburgh Medical Center (UPMC) Shadyside in Pittsburgh, Pennsylvania. UPMC Shadyside initiated its TCAB efforts with an interdisciplinary initiative, involving registered nurses (RNs), nursing assistants, registered dietitians (RDs), and medical doctors (MDs), to transform nutritional services for medical-surgical inpatients. The Patient Controlled Liberalized Diet Program, piloted in late 2003 and rolled-out house-wide in August, 2004, puts the patient in control. The goal is to improve nutritional status and satisfaction among inpatients by empowering them to make menu selections and providing individualized nutrition education. Positive quantitative and qualitative outcomes have resulted, leading to plans for system-wide (19-hospital) spread and further programmatic evolution.